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A nurse is reinforcing teaching with a newly licensed nurse about age-related changes that affect medication administration for older adult clients. Which of the following information should the nurse include?
- A. Hepatic enzymes process medications more rapidly.
- B. Gastric emptying rate increases.
- C. Brain receptors become less sensitive to medications.
- D. Renal excretion time slows for medication.
Correct Answer: D
Rationale: The correct answer is D: Renal excretion time slows for medication. As individuals age, there is a decline in renal function, leading to a decrease in glomerular filtration rate and renal blood flow. This results in a slower excretion of medications from the body, leading to potential accumulation and increased risk of toxicity. Choices A, B, and C are incorrect as hepatic enzymes may actually decrease in function with age, gastric emptying rate tends to slow down, and brain receptors can become more sensitive rather than less sensitive to medications in older adults.
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A nurse is reviewing the medical record of a client who is to start using a scopolamine patch for postoperative nausea and vomiting. Which of the following findings is a contraindication for the client to receive the medication?
- A. Ménière's disease
- B. Increased lacrimation
- C. Narrow-angle glaucoma
- D. Urinary frequency
Correct Answer: C
Rationale: The correct answer is C: Narrow-angle glaucoma. Scopolamine can cause pupillary dilation, leading to an increase in intraocular pressure, which can worsen narrow-angle glaucoma. This can potentially result in a sudden increase in pressure within the eye, leading to severe pain, vision changes, and even blindness. Therefore, it is crucial to avoid giving scopolamine to clients with narrow-angle glaucoma to prevent these serious complications.
Choice A: Ménière's disease is not a contraindication for scopolamine patch use.
Choice B: Increased lacrimation is not a contraindication for scopolamine patch use.
Choice D: Urinary frequency is not a contraindication for scopolamine patch use.
A nurse is caring for a client who has Graves' disease and is to start therapy with propylthiouracil. The nurse should expect which of the following outcomes?
- A. Decreased heart rate
- B. Decreased WBC count
- C. Increased Hgb
- D. Increased blood pressure
Correct Answer: A
Rationale: The correct answer is A: Decreased heart rate. Propylthiouracil is an antithyroid medication used to treat hyperthyroidism in conditions like Graves' disease. It works by inhibiting the production of thyroid hormones. Since hyperthyroidism can cause an increased heart rate due to the excess thyroid hormones, the expected outcome of propylthiouracil therapy is a decreased heart rate as it helps normalize thyroid hormone levels. The other choices are incorrect because propylthiouracil does not directly affect WBC count (B), Hgb levels (C), or blood pressure (D) in the context of treating hyperthyroidism.
A nurse is reinforcing teaching with the parents of a 1-year-old client following the administration of the measles, mumps, and rubella virus vaccine (MMR). Which of the following adverse effects should the nurse instruct the parents to report to the provider?
- A. Glandular swelling around the jaw
- B. Redness around the injection site
- C. Temperature 37.3° C (99.2° F)
- D. Shortness of breath
Correct Answer: D
Rationale: The correct answer is D: Shortness of breath. Shortness of breath can indicate a severe allergic reaction or anaphylaxis, which is a rare but serious adverse effect of the MMR vaccine. It is crucial to report this immediately to the healthcare provider for prompt evaluation and management to prevent any complications.
A: Glandular swelling around the jaw is a common and mild side effect of the MMR vaccine, typically resolving on its own and not requiring immediate medical attention.
B: Redness around the injection site is a common and expected reaction to the vaccine, usually resolving without intervention.
C: A temperature of 37.3° C (99.2° F) is a low-grade fever, which can be a normal response to vaccination and typically does not require urgent medical attention.
A nurse is caring for a client who had abdominal surgery. The client is grimacing and has a respiratory rate of 24/min. Which of the following actions should the nurse take first?
- A. Check the client's current level of pain.
- B. Play music in the client's room as a distraction.
- C. Assist the client to reposition in bed.
- D. Offer the client a cold compress.
Correct Answer: A
Rationale: The correct answer is A, checking the client's current level of pain. This is the priority because the client is grimacing, indicating discomfort. Assessing the pain level is crucial in determining the appropriate intervention. It helps in providing timely pain relief and ensuring the client's well-being. Choices B, C, and D are incorrect because they do not address the immediate need of assessing and managing the client's pain. Playing music, repositioning the client, or offering a cold compress may be helpful interventions, but they should come after evaluating the client's pain level.
A nurse is caring for a client who has prescriptions for spironolactone and lisinopril. The nurse should monitor for which of the following adverse effects?
- A. Hyperkalemia
- B. Hypoglycemia
- C. Hypokalemia
- D. Hyperglycemia
Correct Answer: A
Rationale: The correct answer is A: Hyperkalemia. Spironolactone is a potassium-sparing diuretic, which can lead to elevated potassium levels (hyperkalemia). Lisinopril is an ACE inhibitor that may also contribute to increased potassium levels. Monitoring for hyperkalemia is essential due to the risk of serious cardiac arrhythmias. Hypoglycemia (choice B) and hyperglycemia (choice D) are not typically associated with these medications. Hypokalemia (choice C) is the opposite of what is expected with spironolactone.